Digital Antianxiety Treatment and Cognitive Performance: an Experimental Study

Last registered on December 18, 2019
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Pre-Trial

Trial Information

General Information

Title
Digital Antianxiety Treatment and Cognitive Performance: an Experimental Study
RCT ID
AEARCTR-0005161
Initial registration date
December 10, 2019

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
December 18, 2019, 10:57 AM EST

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Country
Switzerland
Region

Primary Investigator

Name
Simona Grassi
Affiliation
King's Business School, King's College London
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Other Primary Investigator(s)

PI Name
Mark Lambiris
PI Affiliation
Swiss Tropical and Public Health Institute
Contact Investigator
PI Name
Elisa Cavatorta
PI Affiliation
Department of Political Economy, King's College London
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Additional Trial Information

Status
Completed
Start date
2014-10-20
End date
2014-11-21
Keywords
Gender, Health, Other
Additional Keywords
JEL code(s)
C91, D91, I1, J16
Secondary IDs
Abstract
We study the impact of an innovative antianxiety digital treatment on performance in a cognitive demanding task using a randomized control trial design. We exogenously manipulate a cognitive bias associated with anxiety – the tendency to disproportionately
allocate attention to negative stimuli – in a group of young men and women using a digital treatment called Cognitive Bias Modification. CBM treatment reduces attention bias by training individual attention. It is a computer-based training in which pairs of threatening and neutral visual stimuli appear sequentially on the screen. The subject is trained to divert attention away from threatening stimuli by requiring repeated identification of the location of the neutral stimulus in a pair of neutral and threatening stimuli. We observe that the treatment reduces the cognitive bias of treated women and significantly improves their performance in the cognitive task.
External Link(s)

Registration Citation

Citation
Cavatorta, Elisa, Simona Grassi and Mark Lambiris. 2019. "Digital Antianxiety Treatment and Cognitive Performance: an Experimental Study." AEA RCT Registry. December 18. https://doi.org/10.1257/rct.5161-1.0
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Experimental Details

Interventions

Intervention(s)
CBM treatment aims to mitigate the attention bias (a cognitive bias associated to anxiety) that manifests with a disproportionate (subconscious) focus towards threatening stimuli. CBM training corrects the bias by re-diverting the focus towards neutral or positive stimuli. The treatment is computer-based and involves the rapid sequential appearance of pairs of visual stimuli on the screen. We adopted the version of CBM that uses pairs of photographs of human faces as visual stimuli. In each pair of photographs, the face of the
same person appears with an angry expression (threat stimulus) and an emotionally and an emotionally
neutral expression (neutral stimulus). Participants see each pair of angry and neutral faces at the center of their computer screen for 500 milliseconds (ms), before the faces disappear. The photographs are juxtaposed from left to right with a space in between. The location of the angry and the neutral faces on the right or on the left of the screen is randomized. After the faces have disappeared, a probe (in the form of a small cross) pops up for 500 ms at the location of one of the two images. The task for the participant is to identify the location of the probe as rapidly and accurately as possible by clicking on a prespecified key on the keyboard, one for the left and one for the right position. Then, another screen with another pair of faces appears and the procedure repeats. A CBM session consists of 360 consecutive
screens. A session lasts for about 10 minutes. The participants in our study completed a minimum of 16 sessions (one per day).
Intervention Start Date
2014-10-20
Intervention End Date
2014-11-21

Primary Outcomes

Primary Outcomes (end points)
Changes in: 1) Measures of attention bias 2) Performance in a cognitive task
Primary Outcomes (explanation)
1) Measures of attention bias: response time to identify a neutral stimulus versus a threat stimulus
2) Performance in a cognitive task: measured by the number of attempted questions and correct answers to a selection of questions from the Raven Progressive Matrices test completed within 10 minutes.

Secondary Outcomes

Secondary Outcomes (end points)
3) Confidence in the cognitive test result 4) Decision under uncertainty
Secondary Outcomes (explanation)
3) Confidence in the cognitive test result: measured by a price-list type task played in anonymous (random) pairs. Each decision consists in choosing between Option 1 - an uncertain gamble between a fixed payoff with increasing winning probability and a payoff of zero - and Option 2 - a gamble where the high payoff materialises only if the actual subject's performance in the cognitive task is higher than that of the randomly chosen partner.
4) Decision under uncertainty: four price-list type tasks. Tasks A and B are value equivalent tasks. Task A elicits the equivalence between a certain payoff and a gamble with fixed probability and varying payoffs. Task B elicits the lowest payoff in a gamble (x1, x2, q) that is considered indifferent to task's A gamble.

Experimental Design

Experimental Design
The experiment is based on a longitudinal design with randomization of the treatment at the individual level. Participants took part in a baseline laboratory session that included the first CBM intervention. Part of the CBM treatment was conducted at home, over a
period of three weeks, for a total of 14 CBM completed sessions at home. The experiment concluded with a follow-up laboratory session that included the last CBM session. We incentivized participation with a contribution of CHF 110 (approximately GBP 91) to be
paid at the end of the study on condition of full compliance.
Experimental Design Details
Randomization Method
In office by computer
Randomization Unit
individual level
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
300 not clustered
Sample size: planned number of observations
300
Sample size (or number of clusters) by treatment arms
Total: 261 subjects completed the training.
Men: 67 in Treatment group and 63 in Control group
Women: 65 in Treatment and 66 in Control group
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
Faculty of Business and Economics (HEC Lausanne)
IRB Approval Date
2014-08-18
IRB Approval Number
N/A, approved under acronym "LAGRA"
Analysis Plan

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
Yes
Intervention Completion Date
November 21, 2014, 12:00 +00:00
Data Collection Complete
Yes
Data Collection Completion Date
November 21, 2014, 12:00 +00:00
Final Sample Size: Number of Clusters (Unit of Randomization)
261
Was attrition correlated with treatment status?
No
Final Sample Size: Total Number of Observations
261
Final Sample Size (or Number of Clusters) by Treatment Arms
Treated: 132 Control: 129
Data Publication

Data Publication

Is public data available?
No

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Program Files

Program Files
No
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials